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American Journal of Physical Medicine & Rehabilitation:
CME Article: CM: CME Article*2003 Series*Number 4

Sagittal Plane Loading Response During Gait in Different Age Groups and in People with Knee Osteoarthritis

Chen, Carl P. C. MD; Chen, Max J. L. MD; Pei, Yu-Cheng MD; Lew, Henry L. MD, PhD; Wong, Pong-Yuen MD; Tang, Simon F. T. MD

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Abstract

Chen CPC, Chen MJL, Pei YC, Lew HL, Wong PY, Tang SFT: Sagittal plane loading response during gait in different age groups and in people with knee osteoarthritis. Am J Phys Med Rehabil 2003;82:307–312.

Objective: To investigate the gait patterns and the sagittal ground reaction forces in different age groups and in people with knee osteoarthritis.

Design: Motion analysis and force platform data were collected for a total of 55 female subjects capable of independent ambulation. Subjects were divided into three groups consisting of the control group, the elderly group, and the osteoarthritis knee group. Gait parameters of walking velocity, cadence, step length, stride time, single- and double-support time, and sagittal ground reaction forces were obtained during comfortable walking speed. Gait analysis was performed in a tertiary hospital’s gait laboratory. Variables were analyzed using a univariate repeated-measures analysis of variance. Statistical significance was set at a value of P < 0.05.

Results: The osteoarthritis knee group had slower walking velocity, lower cadence, and longer stride time as compared with the elderly and young control groups (P < 0.05). In ground reaction force studies, the first peak time, expressed in percentage of gait cycle, was significantly longer in the osteoarthritis knee group (20.8 ± 3.2) as compared with the elderly (17.8 ± 2.0) and young control groups (17.1 ± 1.8, P < 0.01). The force during time of minimal midstance was larger in the osteoarthritis knee group (90.9 ± 5.3) as compared with the elderly and young control groups (P < 0.05). The second peak force was significantly smaller in the osteoarthritis knee group as compared with the young control group (P < 0.01). The force change in the midfoot region in the osteoarthritis knee and elderly groups revealed more loading force onto the midfoot region during midstance as compared with the young control group (P < 0.01).

Conclusion: Gait parameters in the elderly and osteoarthritis knee patients were characterized by slower walking velocity, lower cadence, shorter step length, longer stride time, and longer double-support time. Less heel contact and push-off forces were noticed in these two groups, with more loading force onto the midfoot during midstance.

© 2003 Lippincott Williams & Wilkins, Inc.

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